CEA Prep Practice Exam Questions and Answers (Verified)
The patient is exhibiting a Left upper lobe lingula
productive cough and a low- Ratonale: Lingular consolidation is described in this
grade fever. Chest X-ray on question precisely. If the cardiac margin/silhouette is
PA view shows a left lower obliterated by the mass, the lesion is either right middle lobe
chest area of consolidation or left upper lobe lingula.
adjacent to the left border of
the heart approximately 2 rib
spaces above the costophrenic
angle. The lateral x-ray view
shows this lesion absent of
the window posterior to the
cardiac silhouette. Which is the
most likely location of this area
of focal consolidation?
*Left upper lobe apex
*Right middle lobe
*Left upper lobe lingula
*Left lower lobe
The inability to fully relax the Diastolic dysfunction
Rationale: The inability for the heart to relax is a trademark
myocardium during relaxation
of the diagnosis of diastolic dysfunction and is common in
is a trademark of which of the
patients with thickened hypertrophic myocardium.
following diagnoses?
An otherwise healthy Calcium channel blocker
African American adult Rationale: African American patients per JNC8
male has been diagnosed Hypertension Guidelines should be managed with a
with hypertension. He has dihydropyridine calcium channel blocker such as
been restricting his salt intake, amlodipine (Norvasc) as first line management therapy for
eating a DASH (Dietary hypertension not at goal with DASH and lifestyle
Approaches to Stop modifications.
Hypertension) diet, and
,exercising more, but his
blood pressure is still elevated.
Which is the BEST
medication to prescribe
him?
CT angiography of the chest
Rationale: CT angiography is considered the standard of care
Your patient has been diagnosed for measuring vascular luminal dimensions with contrast. CT
with a
PE protocol is not timed properly for the aorta (it's timed for
4.5cm ascending aortic
the pulmonary artery). Although a plain film is able to catch
aneurysm. Which medical
large aneurysms at times, they are not able to provide multi-
imaging is considered standard
axis reconstruction needed to accurately measure the size.
of care for serial
Transesophageal echo is not needed to accurately
surveillance?
measure the aorta and requires the patient to undergo
sedation which is unnecessary.
Which of the following phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors.
medications does not cause
The remaining three all have beta receptor activity.
beta 1 stimulation?
Congestive heart failure
A 50-year-old woman with a Rationale: Of the available options, the most accurate
history of hypertension response is congestive heart failure as it is signifying both a
presents with dyspnea on right ventricular back up with jugular venous extension and
exertion and orthopnea. On crackles on lung assault, which are suggestive of left
examination, she has jugular ventricular back up. it is possible the patient may have an
venous distention and acute myocardial infarction that precipitated this, however, a
bilateral crackles on lung patient has not described that, rather is only describing
auscultation. dyspnea on exertion and orthopnea, which both speak to a
What is the most likely diagnosis? state of fluid overload. The only appropriate response of
these available is congestive heart failure.
,Your patient with a history of Ordering a transthoracic echocardiogram and order a
HFrEF (heart failure with Lifevest if EF is less than 35% Rationale: The patient should
reduced ejection fraction) with have a protective mechanism such as an implantable
an ejection fraction of 40% automated cardioverter defibrillator (AICD) or a Lifevest if
who is also not on optimal the EF is less than 35% due to the increased risk of sudden
medical therapy has been cardiac death with low EF states. Since most patients are
diagnosed with a myocardial not eligible for 90 days for an AICD in this state, optimizing
infarction this admission and their medication regimen and repeating an echo in 2-3
received emergent months to re-evaluate for improvement in their EF is
placement of a drug-eluting required by most insurance companies. A baseline echo is
stent to the left anterior needed at discharge to provide a baseline for improvement vs
descending artery. As the their repeat echo in 2- 3 months.
medical home who will Dual anti-platelet therapy is required for 12 months minimum post-MI.
A Holter monitor does not provide any conceivable benefit
manage this patient after
for this patient as presented.
discharge, which medication
strategy would you expect to
be a priority in the patient's
care?
Caucasians
Which of the following Rationale: Statistically African Americans, Native
people groups represent the Hawaiians, and American Indians are at at increased risk of
least risk of cardiac disease? cardiac disease due to higher rates of hypertension,
diabetes, and obesity than Caucasians.
A 65-year-old woman presents a statin drug.
for a Rationale: Bile acid sequestrants and cholesterol absorption
follow-up examination. She is a inhibitors may be useful in reducing ASVD risk, but for a
smoker, and her hypertension patient who is an active smoker with premature coronary
is now adequately controlled disease history (less than age 65 for women), has
with medication. Her mother hypertension and is far from an LDL goal, this patient is
died at age 40 from a heart most certainly a candidate for statin therapy, which
attack. The fasting lipid profile represents the most aggressive therapy option of these
shows cholesterol = 240 four listed.
mg/dL, HDL = 30, and LDL =
200. In addition to starting
, therapeutic lifestyle changes,
the nurse practitioner should
start the patient on:
Peripheral neuropathy
Which of the following Ratioanle: Although patients with hypertension frequently
end-organ sequelae is have peripheral neuropathy, it is only directly attributed to
not directly caused by patients who are also diabetic and is commonly found in
uncontrolled non-hypertensive diabetic patients. Proteinuria, AV nicking,
hypertension? and hemorrhagic stroke are all caused by uncontrolled
hypertension.
Genetic predisposition
Preventive cardiac care Rationale: Smoking cessation, exercise, and medication
should focus primarily on compliance all represent modifiable risk factors and should
addressing all the following be the focus of preventive care. Non-modifiable risk factors
except? such as age, gender, genetic/family history should not be
the primary focus of prevention.
Oral contraceptives
Rationale: These are classic symptoms of polycystic
ovarian syndrome and the patient should be treated with
oral contraceptives to help stabilize their estrogen and
progesterone. Additionally, they may be managed on
metformin and/or spironolactone for their PCOS.
A 33-year-old woman Oral contraceptive pills (OCPs) are often the first
presents with irregular pharmacological treatment for polycystic ovary
menstrual cycles, hirsutism, syndrome (PCOS) because they help manage in several
and obesity. Laboratory tests ways: Menstrual irregularities: OCPs can help regulate
reveal elevated serum menstrual cycles, making periods lighter and more regular.
testosterone and LH ratio > 2:1. This is important because irregular ovulation can lead to
What is the most appropriate endometrial hyperplasia, which is a buildup of uterine tissue
initial treatment? that can increase the risk of uterine cancer.
The patient is exhibiting a Left upper lobe lingula
productive cough and a low- Ratonale: Lingular consolidation is described in this
grade fever. Chest X-ray on question precisely. If the cardiac margin/silhouette is
PA view shows a left lower obliterated by the mass, the lesion is either right middle lobe
chest area of consolidation or left upper lobe lingula.
adjacent to the left border of
the heart approximately 2 rib
spaces above the costophrenic
angle. The lateral x-ray view
shows this lesion absent of
the window posterior to the
cardiac silhouette. Which is the
most likely location of this area
of focal consolidation?
*Left upper lobe apex
*Right middle lobe
*Left upper lobe lingula
*Left lower lobe
The inability to fully relax the Diastolic dysfunction
Rationale: The inability for the heart to relax is a trademark
myocardium during relaxation
of the diagnosis of diastolic dysfunction and is common in
is a trademark of which of the
patients with thickened hypertrophic myocardium.
following diagnoses?
An otherwise healthy Calcium channel blocker
African American adult Rationale: African American patients per JNC8
male has been diagnosed Hypertension Guidelines should be managed with a
with hypertension. He has dihydropyridine calcium channel blocker such as
been restricting his salt intake, amlodipine (Norvasc) as first line management therapy for
eating a DASH (Dietary hypertension not at goal with DASH and lifestyle
Approaches to Stop modifications.
Hypertension) diet, and
,exercising more, but his
blood pressure is still elevated.
Which is the BEST
medication to prescribe
him?
CT angiography of the chest
Rationale: CT angiography is considered the standard of care
Your patient has been diagnosed for measuring vascular luminal dimensions with contrast. CT
with a
PE protocol is not timed properly for the aorta (it's timed for
4.5cm ascending aortic
the pulmonary artery). Although a plain film is able to catch
aneurysm. Which medical
large aneurysms at times, they are not able to provide multi-
imaging is considered standard
axis reconstruction needed to accurately measure the size.
of care for serial
Transesophageal echo is not needed to accurately
surveillance?
measure the aorta and requires the patient to undergo
sedation which is unnecessary.
Which of the following phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors.
medications does not cause
The remaining three all have beta receptor activity.
beta 1 stimulation?
Congestive heart failure
A 50-year-old woman with a Rationale: Of the available options, the most accurate
history of hypertension response is congestive heart failure as it is signifying both a
presents with dyspnea on right ventricular back up with jugular venous extension and
exertion and orthopnea. On crackles on lung assault, which are suggestive of left
examination, she has jugular ventricular back up. it is possible the patient may have an
venous distention and acute myocardial infarction that precipitated this, however, a
bilateral crackles on lung patient has not described that, rather is only describing
auscultation. dyspnea on exertion and orthopnea, which both speak to a
What is the most likely diagnosis? state of fluid overload. The only appropriate response of
these available is congestive heart failure.
,Your patient with a history of Ordering a transthoracic echocardiogram and order a
HFrEF (heart failure with Lifevest if EF is less than 35% Rationale: The patient should
reduced ejection fraction) with have a protective mechanism such as an implantable
an ejection fraction of 40% automated cardioverter defibrillator (AICD) or a Lifevest if
who is also not on optimal the EF is less than 35% due to the increased risk of sudden
medical therapy has been cardiac death with low EF states. Since most patients are
diagnosed with a myocardial not eligible for 90 days for an AICD in this state, optimizing
infarction this admission and their medication regimen and repeating an echo in 2-3
received emergent months to re-evaluate for improvement in their EF is
placement of a drug-eluting required by most insurance companies. A baseline echo is
stent to the left anterior needed at discharge to provide a baseline for improvement vs
descending artery. As the their repeat echo in 2- 3 months.
medical home who will Dual anti-platelet therapy is required for 12 months minimum post-MI.
A Holter monitor does not provide any conceivable benefit
manage this patient after
for this patient as presented.
discharge, which medication
strategy would you expect to
be a priority in the patient's
care?
Caucasians
Which of the following Rationale: Statistically African Americans, Native
people groups represent the Hawaiians, and American Indians are at at increased risk of
least risk of cardiac disease? cardiac disease due to higher rates of hypertension,
diabetes, and obesity than Caucasians.
A 65-year-old woman presents a statin drug.
for a Rationale: Bile acid sequestrants and cholesterol absorption
follow-up examination. She is a inhibitors may be useful in reducing ASVD risk, but for a
smoker, and her hypertension patient who is an active smoker with premature coronary
is now adequately controlled disease history (less than age 65 for women), has
with medication. Her mother hypertension and is far from an LDL goal, this patient is
died at age 40 from a heart most certainly a candidate for statin therapy, which
attack. The fasting lipid profile represents the most aggressive therapy option of these
shows cholesterol = 240 four listed.
mg/dL, HDL = 30, and LDL =
200. In addition to starting
, therapeutic lifestyle changes,
the nurse practitioner should
start the patient on:
Peripheral neuropathy
Which of the following Ratioanle: Although patients with hypertension frequently
end-organ sequelae is have peripheral neuropathy, it is only directly attributed to
not directly caused by patients who are also diabetic and is commonly found in
uncontrolled non-hypertensive diabetic patients. Proteinuria, AV nicking,
hypertension? and hemorrhagic stroke are all caused by uncontrolled
hypertension.
Genetic predisposition
Preventive cardiac care Rationale: Smoking cessation, exercise, and medication
should focus primarily on compliance all represent modifiable risk factors and should
addressing all the following be the focus of preventive care. Non-modifiable risk factors
except? such as age, gender, genetic/family history should not be
the primary focus of prevention.
Oral contraceptives
Rationale: These are classic symptoms of polycystic
ovarian syndrome and the patient should be treated with
oral contraceptives to help stabilize their estrogen and
progesterone. Additionally, they may be managed on
metformin and/or spironolactone for their PCOS.
A 33-year-old woman Oral contraceptive pills (OCPs) are often the first
presents with irregular pharmacological treatment for polycystic ovary
menstrual cycles, hirsutism, syndrome (PCOS) because they help manage in several
and obesity. Laboratory tests ways: Menstrual irregularities: OCPs can help regulate
reveal elevated serum menstrual cycles, making periods lighter and more regular.
testosterone and LH ratio > 2:1. This is important because irregular ovulation can lead to
What is the most appropriate endometrial hyperplasia, which is a buildup of uterine tissue
initial treatment? that can increase the risk of uterine cancer.
